| Doctor Name: | MRS. JILL A PETERSEN |
| NPI Number: | 1699872713 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | PT21220 |
| Business Practice Address: | 1807 Short Branch Dr 103 Trinity, FL - 346554424 |
| Business Phone Number: | 7273725500 |
| Business Fax Number: | 7273728500 |
| Mailing Address: | 1807 Short Branch Dr, #103 NEW PORT RICHEY |
| State: | FL |
| Postal Code: | 346554424 |
| Phone Number: | 7273725500 |
| Fax Number: | 7273728500 |
| NPI Enumeration Date: | 09/20/2006 |
| NPI Last Update Date: | 07/02/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT21220 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |